AN AUDIT OF HIV TESTING AND HIV SEROSTATUS IN TUBERCULOSIS PATIENTS, BLANTYRE, MALAWI

Setting: Queen Elizabeth Central Hospital, Blantyre, Malawi. Objective: An audit of voluntary HIV testing, with pre- and post-test counselling, of adult patients diagnosed with all types of tuberculosis. Design: A review of case files of adult patients with tuberculosis registered with the District Tuberculosis Officer, Blantyre, between April 1993 and March 1994. Results: There were 1095 tuberculosis patients, mean age 32 years, of whom 665 (60.7%) had HIV-serological testing. 496 patients (74.6% of those tested) were HIV seropositive. 73% of patients who were hospitalized for the initial intensive phase of treatment were HIV-tested compared with 37% of patients who received ambulatory chemotherapy (P < 0.001). In patients HIV-tested, 5 did not wish to know their results and post-test counselling was done in 516 (78%). 23 patients refused HIV testing. 362 (84%) patients not HIV-tested never received pre-test counselling. Of 664 patients who received 2SRHZ/6HT(E) in hospital, 84 (12.6%) patients died and 8 (1.2%) absconded. The abscondee rate was unrelated to HIV serostatus. Conclusion: A large proportion of tuberculosis patients who receive supervised treatment in hospital accept confidential HIV testing and the abscondee rate is low. The clinical management of patients is improved.